The mission of Prognosis is to explore the nexus at which healthcare policy meets healthcare practice and how one affects the other. This blog makes readers more aware of the innovations taking place in healthcare delivery, financing and technology and the types of public policies that will encourage further progress.

Healthcare In Focus is a public education initiative of the HLC, created to promote a constructive dialogue about the state and future of American healthcare.

For all of the criticisms of this year’s presidential campaign being overly negative and personalized, I actually believe one of the most important failures of the campaign thus far is spotlighted in the New York Times/CBS News poll published in today’s Times.

Despite (or perhaps, because of) the millions of dollars in advertising focused on the issue of Medicare, millions of Americans still don’t understand that the Medicare program as it currently exists can’t last. The campaign has failed, to this point, in educating voters that the status quo – or, as some politicians like to say, Medicare ‘as we know it’ – isn’t a viable option.

The NYT/CBS poll revealed that in three key swing states (Florida, Ohio, Wisconsin), approximately 60 percent of respondents said they preferred that Medicare should continue “as it is today.” Now, to be fair, the other option given in the poll question was a 28-word description of the Romney-Ryan premium support proposal, and we know from work with focus groups that premium support is not a concept that can be adequately explained in just a couple of sentences.

It’s clear, though, to anyone that watches the nonstop TV advertising from political campaigns both national and local that there is much more interest in demonizing opponents over the Medicare issue than there is in actually enlightening voters on the subject. Thus, it’s not surprising that majorities of voters would prefer the safe ground of the Medicare status quo when candidates aren’t emphasizing that:

• The Medicare Board of Trustees has said that the program, as it stands today, will be insolvent in a little over a decade – in 2024.

• 10,000 Americans per day are turning 65 and will receive approximately three dollars in healthcare benefits for every one dollar they paid in payroll taxes over the course of their working years

• It is a misnomer to say that any measure that doesn’t cut Medicare benefits to seniors, but that reduces payments to providers instead, protects beneficiaries. An American Medical Association survey from 2010 already warns that one of every three primary care doctors won’t take new Medicare patients because of low reimbursements.

What we need to hear more frequently on the campaign trail is that voters do have a choice, but it’s not between changing Medicare or keeping the program as it is. Rather, voters need to decide how they want political leaders to change a program that can’t be sustained in its current form.

We have approximately 75 days left in the campaign to see that realistic discussion take place. Fingers crossed.